高危增生性视网膜病变的视网膜脱离不同手术方式效果的比较  

Comparison on the efficacy of different surgical methods for rhegmatogenous retinal detachment with high risk of proliferative vitretinopathy

作　　者：万文萃[1] 金学民[1] 杨果果 刘宇莹[1] 庞雪娜 

机构地区：[1]郑州大学第一附属医院眼科郑州大学眼底病研究所,450052

出　　处：《中华眼外伤职业眼病杂志》2015年第5期354-357,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 比较两种不同手术方式对术后易于发生增生性玻璃体视网膜病变（PVR）的孔源性视网膜脱离的治疗效果.方法 回顾性研究.术后易于发生PVR的孔源性视网膜脱离74例（74眼）,包括视网膜脱离超过2个象限,或视网膜裂孔大于一个钟点位,或术前有PVR,或玻璃体积血者.随机分为两组：单纯玻璃体视网膜手术组36例,玻璃体视网膜手术联合巩膜环扎术组38例,两组术前一般条件相似.术后随访3个月以上,比较手术效果,比较的指标为单次手术复位率.结果 联合手术的单次手术复位率为78.95％,明显高于单纯玻璃体视网膜手术的44.44％（x2=0.025,P=0.017）.结论 术后易于发生PVR的孔源性视网膜脱离进行玻璃体视网膜手术联合巩膜环扎术的单次手术解剖复位率高.Objective To compare the clinical efficacy of using pars plana vitreoretinal surgery （PPVR） combined with scleral encircling operation and PPVR alone in patients of rhegmatogenous retinal detachment with high risk of postoperative proliferative vitreoretinopathy （PVR）.Methods A retrospective study.Seventy-four eyes of 74 patients of rhegmatogenous retinal detachment with high risk of PVR were collected including retinal detachment more than two quadrants,retinal tears range more than 1 clock,preoperative PVR,or vitreous hemorrhage.The patients were randomly divided into two groups：23 G PPVR alone group （36 cases） and PPVR combined with scleral encircling groups （38 cases）.The conditions of patients in two groups were similar.The follow-up time was more than 3 months.The reattachment rates by single surgery between two groups were compared.Results The reattachment rate by single surgery in combined surgery group was 78.95% which was significantly higher than 44.44% in PPVR alone group （F =0.026,P =0.025）.Conclusion For patients with high risk of PVR,PPV combined with scleral encircling has higher success rate of anatomical reattachment compared with PPV alone.

关 键 词：视网膜脱离 孔源性 玻璃体视网膜手术 巩膜环扎术 

分 类 号：R779.6[医药卫生—眼科]